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A Study of the Safety and Activity of Eculizumab in Pediatric Participants With Relapsing Neuromyelitis Optica Spectrum Disorder

Primary Purpose

Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder

Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Eculizumab
Sponsored by
Alexion
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neuromyelitis Optica focused on measuring Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder, Devic's Disease, Transverse Myelitis, Optic Neuritis, Relapse, Eculizumab, Soliris, CNS Autoimmune Disorders, Demyelinating Disorders, NMO, NMOSD

Eligibility Criteria

2 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female participants aged 2 years to < 18 years with body weight ≥ 10 kilograms (kg).
  2. Vaccinated against Neisseria meningitidis within 3 years prior to, or at the time of initiating eculizumab. Participants who initiate study drug treatment less than 2 weeks after receiving a meningococcal vaccine must receive appropriate prophylactic antibiotics until 2 weeks after the vaccination.
  3. Documented vaccination against haemophilus influenzae type b and streptococcus pneumoniae infections at least 2 weeks prior to dosing as per local and country-specific immunization guidelines for the appropriate age group.
  4. Anti-aquaporin-4 antibody-positive and diagnosis of NMOSD as defined by the 2015 International Panel for Neuromyelitis Optica Diagnosis criteria.
  5. Historical Relapse Rate of at least 2 relapses in the last 2 years, and with at least 1 relapse in the year prior to Screening.
  6. EDSS score ≤ 7.
  7. Participants who enter the study receiving supportive immunosuppressive therapies (ISTs) for the prevention of relapse, either in combination or monotherapy, must be on a stable dosing regimen of adequate duration.
  8. Female participants of childbearing potential must have a negative pregnancy test (serum human chorionic gonadotropin) at Screening and follow protocol-specified contraception guidance for avoiding pregnancy while on treatment and for 5 months after the last dose of eculizumab.
  9. Male participants with a female spouse/partner of childbearing potential or a pregnant or breastfeeding spouse or partner must agree to use double barrier contraception (male condom plus appropriate barrier method for the female partner) while on treatment and for at least 5 months after the last dose of eculizumab.

Exclusion Criteria:

  1. Parent or legal guardian is an Alexion employee.
  2. Pregnant, breastfeeding, or intending to conceive during the course of the study.
  3. Participants known to be human immunodeficiency virus positive or with congenital immunodeficiency.
  4. Unresolved meningococcal or other serious infection.
  5. Any unresolved acute or chronic systemic bacterial or other infection that is clinically significant in the opinion of the Investigator and has not been treated with appropriate antibiotics.
  6. Use of rituximab or other biologicals such as tocilizumab within 6 months prior to Screening.
  7. Use of mitoxantrone within 3 months prior to Screening.
  8. Use of intravenous immunoglobulin or plasma exchange within 3 weeks prior to Screening.
  9. Use of immunomodulatory therapies for multiple sclerosis within 3 months prior to Screening.
  10. Has previously received treatment with eculizumab or other complement inhibitors.

Sites / Locations

  • Clinical Trial Site
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Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Eculizumab

Arm Description

All participants will receive open-label eculizumab by intravenous infusion during the Primary Treatment Period, starting on Day 1 and for a total of 52/53 weeks. The dosing regimen will be based on the participant's body weight. As body weight changes during the study, the participant's weight cohort and dose may change accordingly. After completing the 52/53-week Primary Treatment Period, participants may continue receiving eculizumab in the Extension Treatment Period for 104 weeks.

Outcomes

Primary Outcome Measures

Change From Baseline In The Annualized Relapse Rate At 52/53 Weeks
Time To First Relapse

Secondary Outcome Measures

Change From Baseline In Expanded Disability Status Scale (EDSS) Score At 52/53 Weeks In Participants ≥5 Years Of Age
Change From Baseline In The Hauser Ambulatory Index Score At 52/53 Weeks
Change From Baseline In Pediatric Quality Of Life Inventory (PedsQL) At 52/53 Weeks In Participants ≥5 Years Of Age
Change From Baseline In Pediatric Quality Of Life Inventory Parent Proxy (PedsQL Parent Proxy) At 52/53 Weeks In Participants < 5 Years Of Age
Change From Baseline In Visual Acuity As Measured By The Snellen Or LEA Symbols Eye Chart Examination At 52/53 Weeks
Change From Baseline In Confrontational Visual Fields As Measured During Ophthalmologic Examination At 52/53 Weeks
Change From Baseline In Color Vision As Measured During Ophthalmologic Examination At 52/53 Weeks
Serum Eculizumab Concentration Over Time
Serum Free Complement Protein 5 Concentrations Over Time
In Vitro Hemolytic Activity Over Time

Full Information

First Posted
November 5, 2019
Last Updated
October 13, 2023
Sponsor
Alexion
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1. Study Identification

Unique Protocol Identification Number
NCT04155424
Brief Title
A Study of the Safety and Activity of Eculizumab in Pediatric Participants With Relapsing Neuromyelitis Optica Spectrum Disorder
Official Title
A Phase 2/3 Open-Label, Single-Arm Trial to Evaluate the Safety and Activity of Eculizumab in Pediatric Patients With Relapsing Neuromyelitis Optica Spectrum Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 14, 2020 (Actual)
Primary Completion Date
July 31, 2023 (Actual)
Study Completion Date
July 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alexion

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The objective of this study is to evaluate the safety and efficacy of eculizumab in pediatric participants (aged 2 to < 18 years) with relapsing neuromyelitis optica spectrum disorder (NMOSD).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder
Keywords
Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder, Devic's Disease, Transverse Myelitis, Optic Neuritis, Relapse, Eculizumab, Soliris, CNS Autoimmune Disorders, Demyelinating Disorders, NMO, NMOSD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Eculizumab
Arm Type
Experimental
Arm Description
All participants will receive open-label eculizumab by intravenous infusion during the Primary Treatment Period, starting on Day 1 and for a total of 52/53 weeks. The dosing regimen will be based on the participant's body weight. As body weight changes during the study, the participant's weight cohort and dose may change accordingly. After completing the 52/53-week Primary Treatment Period, participants may continue receiving eculizumab in the Extension Treatment Period for 104 weeks.
Intervention Type
Drug
Intervention Name(s)
Eculizumab
Other Intervention Name(s)
Soliris
Intervention Description
Following a weight-based weekly dose of eculizumab during an induction phase, participants will receive weight-based doses of eculizumab every 2 weeks during the Primary Treatment Period and Extension Treatment Period.
Primary Outcome Measure Information:
Title
Change From Baseline In The Annualized Relapse Rate At 52/53 Weeks
Time Frame
Baseline, Week 52/53
Title
Time To First Relapse
Time Frame
Baseline up to Week 52/53
Secondary Outcome Measure Information:
Title
Change From Baseline In Expanded Disability Status Scale (EDSS) Score At 52/53 Weeks In Participants ≥5 Years Of Age
Time Frame
Baseline, Week 52/53
Title
Change From Baseline In The Hauser Ambulatory Index Score At 52/53 Weeks
Time Frame
Baseline, Week 52/53
Title
Change From Baseline In Pediatric Quality Of Life Inventory (PedsQL) At 52/53 Weeks In Participants ≥5 Years Of Age
Time Frame
Baseline, Week 52/53
Title
Change From Baseline In Pediatric Quality Of Life Inventory Parent Proxy (PedsQL Parent Proxy) At 52/53 Weeks In Participants < 5 Years Of Age
Time Frame
Baseline, Week 52/53
Title
Change From Baseline In Visual Acuity As Measured By The Snellen Or LEA Symbols Eye Chart Examination At 52/53 Weeks
Time Frame
Baseline, Week 52/53
Title
Change From Baseline In Confrontational Visual Fields As Measured During Ophthalmologic Examination At 52/53 Weeks
Time Frame
Baseline, Week 52/53
Title
Change From Baseline In Color Vision As Measured During Ophthalmologic Examination At 52/53 Weeks
Time Frame
Baseline, Week 52/53
Title
Serum Eculizumab Concentration Over Time
Time Frame
Baseline through Week 52/53
Title
Serum Free Complement Protein 5 Concentrations Over Time
Time Frame
Baseline through Week 52/53
Title
In Vitro Hemolytic Activity Over Time
Time Frame
Baseline through Week 52/53

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants aged 2 years to < 18 years with body weight ≥ 10 kilograms (kg). Vaccinated against Neisseria meningitidis within 3 years prior to, or at the time of initiating eculizumab. Participants who initiate study drug treatment less than 2 weeks after receiving a meningococcal vaccine must receive appropriate prophylactic antibiotics until 2 weeks after the vaccination. Documented vaccination against haemophilus influenzae type b and streptococcus pneumoniae infections at least 2 weeks prior to dosing as per local and country-specific immunization guidelines for the appropriate age group. Anti-aquaporin-4 antibody-positive and diagnosis of NMOSD as defined by the 2015 International Panel for Neuromyelitis Optica Diagnosis criteria. Historical Relapse Rate of at least 2 relapses in the last 2 years, and with at least 1 relapse in the year prior to Screening. EDSS score ≤ 7. Participants who enter the study receiving supportive immunosuppressive therapies (ISTs) for the prevention of relapse, either in combination or monotherapy, must be on a stable dosing regimen of adequate duration. Female participants of childbearing potential must have a negative pregnancy test (serum human chorionic gonadotropin) at Screening and follow protocol-specified contraception guidance for avoiding pregnancy while on treatment and for 5 months after the last dose of eculizumab. Male participants with a female spouse/partner of childbearing potential or a pregnant or breastfeeding spouse or partner must agree to use double barrier contraception (male condom plus appropriate barrier method for the female partner) while on treatment and for at least 5 months after the last dose of eculizumab. Exclusion Criteria: Parent or legal guardian is an Alexion employee. Pregnant, breastfeeding, or intending to conceive during the course of the study. Participants known to be human immunodeficiency virus positive or with congenital immunodeficiency. Unresolved meningococcal or other serious infection. Any unresolved acute or chronic systemic bacterial or other infection that is clinically significant in the opinion of the Investigator and has not been treated with appropriate antibiotics. Use of rituximab or other biologicals such as tocilizumab within 6 months prior to Screening. Use of mitoxantrone within 3 months prior to Screening. Use of intravenous immunoglobulin or plasma exchange within 3 weeks prior to Screening. Use of immunomodulatory therapies for multiple sclerosis within 3 months prior to Screening. Has previously received treatment with eculizumab or other complement inhibitors.
Facility Information:
Facility Name
Clinical Trial Site
City
San Francisco
State/Province
California
ZIP/Postal Code
94016
Country
United States
Facility Name
Clinical Trial Site
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20001
Country
United States
Facility Name
Clinical Trial Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33101
Country
United States
Facility Name
Clinical Trial Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30301
Country
United States
Facility Name
Clinical Trial Site
City
Rockville
State/Province
Maryland
ZIP/Postal Code
20847
Country
United States
Facility Name
Clinical Trial Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02101
Country
United States
Facility Name
Clinical Trial Site
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27514
Country
United States
Facility Name
Clinical Trial Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19019
Country
United States
Facility Name
Clinical Trial Site
City
Edmonton
State/Province
Alberta
Country
Canada
Facility Name
Clinical Trial Site
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
Clinical Trial Site
City
Regensburger Straße
State/Province
Goettingen
Country
Germany
Facility Name
Clinical Trial Site
City
Genoa
Country
Italy
Facility Name
Clinical Trial Site
City
Rome
Country
Italy
Facility Name
Clinical Trial Site
City
Yokohama
Country
Japan
Facility Name
Clinical Trial Site
City
Seoul
Country
Korea, Republic of
Facility Name
Clinical Trial Site
City
Barcelona
Country
Spain
Facility Name
Clinical Trial Site
City
Sevilla
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of the Safety and Activity of Eculizumab in Pediatric Participants With Relapsing Neuromyelitis Optica Spectrum Disorder

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